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Abstract

PURPOSE:

Triweekly delivery of cisplatin concurrent with a course of radiation therapy (RT) has been the standard regimen for treatment of locally advanced nasopharyngeal carcinoma (NPC) despite a high level of concern regarding treatment-related complications. We conducted a randomized phase II study to compare weekly and triweekly cisplatin delivery during RT with respect to efficacy and toxicity profiles.

MATERIAL AND METHODS:

Patients with locally advanced NPC (stage II-IVb) were randomly assigned to a regimen of either seven doses of cisplatin (40mg/m(2)) given once a week or three doses of cisplatin (100mg/m(2)) given every 3weeks concurrently during RT.

RESULTS:

Of 109 eligible patients, 53 were assigned to the weekly regimen and 56 to the triweekly regimen. The two groups were comparable with respect to demographic and clinical characteristics. There were no significant differences in mean RT dose (68.3Gy vs. 67.3Gy, p=0.559) and mean cisplatin dose (248.9mg/m(2)vs. 256.6mg/m(2), p=0.433) between the two regimens. The primary endpoint was 3-year progression-free survival, which was not different between the regimens (64.9% vs. 63.8%, p=0.074). Overall, the occurrence of grade 3-4 toxicities was similar between the two arms (47.2% vs. 39.3%, p=0.443). Quality of life (QoL) related to functional outcomes 3weeks after treatment completion was better for the weekly regimen.

CONCLUSIONS:

Although no definitive conclusions can be made, a once-weekly cisplatin regimen appears to be associated with improved QoL and is not inferior to the standard triweekly regimen with respect to efficacy and toxicity profiles. 

Author information

Lee JY1, Sun JM1, Oh DR2, Lim SH1, Goo J3, Lee SH1, Kim SB4, Park KU5, Kim HK6, Hong DS7, Kim JS8, Kim SG9, Yi SY10, Yun HJ11, Hyun MS12, Kim HJ13, Jung SH3, Park K1, Ahn YC14, Ahn MJ15.

1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

3Department of Biostatistics and Bioinformatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

4Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

5Division of Hematology-Oncology, Department of Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.

6Division of Hematology-Oncology, Department of Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea.

7Division of Hematology-Oncology, Department of Medicine, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

8Division of Hematology-Oncology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

9Division of Hematology-Oncology, Department of Medicine, Pusan National University, Yangsan, Republic of Korea.

10Division of Hematology-Oncology, Department of Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyaung, Republic of Korea.

11Division of Hematology-Oncology, Department of Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.

12Division of Hematology-Oncology, Department of Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.

13Division of Hematology-Oncology, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.

14Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: ahnyc@skku.edu.

15Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: silkahn@skku.edu.